Bone Cancer: About Primary Bone Cancer

Primary bone cancer, which means cancer that begins in bone tissue, is rare. According to the American Cancer Society, approximately 2,380 new cases of primary bone cancer will be diagnosed in 2008 — a figure that represents less than 0.2 percent of all cancers.

Primary bone cancer can grow in any of the 206 bones of the adult human body, but it occurs most often in the long bones of the arms and legs. Although bone cancer can present itself at any age, the most common types occur in children and young adults. Bone cancers form in the cells that make hard bone tissue. Cancers that arise in the cells produced in the bone marrow, such as leukemia, multiple myeloma, and lymphoma, are not considered bone cancers, although they do affect the bone and may require orthopaedic management.

Benign (noncancerous) bone tumors are more common than malignant (cancerous) ones. Although benign tumors do not spread and are rarely life threatening, both types may grow and compress healthy bone tissue and absorb or replace it with abnormal tissue.

Osteosarcoma

Osteosarcoma is the most common type of primary bone cancer, making up 35 percent of bone cancer cases. This cancer affects primarily children and young adults between the ages of ten and 25. Osteosarcoma often starts in the ends of bones, where new tissue forms as children grow. It occurs most often in the knee.

Chondrosarcoma

Chondrosarcomas, one of the most common types of bone cancer in adults over age 50, form in cartilage — usually around the pelvis, knee, shoulder, or upper part of the thigh. These cancers make up 26 percent of all bone cancer cases.

Ewing’s Sarcoma

Ewing’s sarcoma usually occurs in the middle part of bones, arising most often in the hip, ribs, upper arm, and thighbone. Like osteosarcoma, this cancer affects primarily children and young adults between the ages of ten and 25. Ewing’s sarcoma is responsible for 16 percent of bone cancer cases.

Rarer Bone Cancers

The following types of bone cancer are rare and occur primarily in adults:

Fibrosarcomas usually appear in the knee or hip area. They can arise in older patients after radiationtherapy for other cancers.

Giant cell tumors, which usually begin in the knee, affect young adults most frequently, and women more often than men.

Chordomas are found most often in the sacrum, which is the lower part of the spine, also known as the tailbone.

Metastatic Cancer to Bone

Metastatic bone cancer — cancer that starts somewhere else in the body and then spreads to the bone — is much more common than primary bone cancer. Although any type of cancer can spread to the bone, the most common types are those of the breast, lung, kidney, thyroid, and prostate. Bone metastases most often arise in the hip, femur (thighbone), shoulder, and spine. Like other types of cancer, those that start in the bone can also spread to other parts of the body.

Risk Factors

Among those who develop bone cancer, 95 percent of people do not have any obvious risk factors. While scientists are not certain what causes bone cancer, a number of factors that may increase a person’s risk have been identified:

Age and Individual History

Bone cancers occur more frequently in children and young adults, particularly those who have had radiation therapy or chemotherapy for other conditions. Bone cancers that appear in young people may also be associated with the rapid growth of bones that occurs during puberty.

Heredity

A small number of bone cancers are due to heredity. For example, children with hereditaryretinoblastoma (an uncommon cancer of the eye) are at a higher risk of developing osteosarcoma. Another hereditary condition that may increase bone cancer risk is Li-Fraumeni syndrome, a disorder caused by a mutation in the p53tumor suppressor gene. This syndrome predisposes people to cancers of the breast and brain, osteosarcoma, and other types of sarcoma.

Paget’s Disease

Adults with Paget’s disease, a noncancerous condition characterized by abnormal development of new bone cells, may be at increased risk for osteosarcoma. Bones affected by Paget’s disease are heavier and thicker, yet weaker than normal bones, and more likely to fracture.

Symptoms

The most common symptom of bone cancer is pain, which is caused either by the spread of the tumor or by the breaking of bone that is weakened by a tumor. Stiffness or tenderness in the bone may also occur. Sometimes there are other symptoms, such as fatigue, fever, swelling, and stumbling. But these symptoms can also be caused by other conditions. Only a doctor can tell for sure whether or not a patient has bone cancer.

abnormal (ab-NOR-mul)

Not normal. An abnormal lesion or growth may be cancer, premalignant (likely to become cancer), or benign (not cancer).

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

affected

Individuals in a pedigree who exhibit the specific phenotype under study.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

ARMS

A soft tissue tumor that is most common in older children and teenagers. It begins in embryonic muscle cells (cells that develop into muscles in the body). It can occur at many places in the body, but usually occurs in the trunk, arms, or legs. Also called alveolar rhabdomyosarcoma.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

benign (beh-NINE)

Not cancerous. Benign tumors may grow larger but do not spread to other parts of the body. Also called nonmalignant.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

bone cancer (bone KAN-ser)

Primary bone cancer is cancer that forms in cells of the bone. Some types of primary bone cancer are osteosarcoma, Ewing sarcoma, malignant fibrous histiocytoma, and chondrosarcoma. Secondary bone cancer is cancer that spreads to the bone from another part of the body (such as the prostate, breast, or lung).

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

bone marrow (bone MAYR-oh)

The soft, sponge-like tissue in the center of most bones. It produces white blood cells, red blood cells, and platelets.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

breast (brest)

Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

cancer (KAN-ser)

A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

cartilage (KAR-tih-lij)

A tough, flexible tissue that lines joints and gives structure to the nose, ears, larynx, and other parts of the body.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

cell (sel)

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

chemotherapy (KEE-moh-THAYR-uh-pee)

Treatment with drugs that kill cancer cells.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

condition (kun-DIH-shun)

In medicine, a health problem with certain characteristics or symptoms.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

disorder (dis-OR-der)

In medicine, a disturbance of normal functioning of the mind or body. Disorders may be caused by genetic factors, disease, or trauma.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

fatigue (fuh-TEEG)

A condition marked by extreme tiredness and inability to function due lack of energy. Fatigue may be acute or chronic.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

fever (FEE-ver)

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

gene (jeen)

The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

hereditary (huh-REH-dih-tayr-ee)

Transmitted from parent to child by information contained in the genes.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

kidney (KID-nee)

One of a pair of organs in the abdomen. Kidneys remove waste from the blood (as urine), produce erythropoietin (a substance that stimulates red blood cell production), and play a role in blood pressure regulation.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

leukemia (loo-KEE-mee-uh)

Cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of blood cells to be produced and enter the bloodstream.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

Li-Fraumeni syndrome (lee-FRAH-meh-nee SIN-drome)

A rare, inherited predisposition to multiple cancers, caused by an alteration in the p53 tumor suppressor gene.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

lung (lung)

One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

lymphoma (lim-FOH-muh)

Cancer that begins in cells of the immune system. There are two basic categories of lymphomas. One kind is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-Hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slow-growing) course and those that have an aggressive (fast-growing) course. These subtypes behave and respond to treatment differently. Both Hodgkin and non-Hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

malignant (muh-LIG-nunt)

Cancerous. Malignant cells can invade and destroy nearby tissue and spread to other parts of the body.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

metastatic (meh-tuh-STA-tik)

Having to do with metastasis, which is the spread of cancer from the primary site (place where it started) to other places in the body.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

multiple myeloma (MUL-tih-pul MY-eh-LOH-muh)

A type of cancer that begins in plasma cells (white blood cells that produce antibodies). Also called Kahler disease, myelomatosis, and plasma cell myeloma.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

mutation (myoo-TAY-shun)

Any change in the DNA of a cell. Mutations may be caused by mistakes during cell division, or they may be caused by exposure to DNA-damaging agents in the environment. Mutations can be harmful, beneficial, or have no effect. If they occur in cells that make eggs or sperm, they can be inherited; if mutations occur in other types of cells, they are not inherited. Certain mutations may lead to cancer or other diseases.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

osteosarcoma (OS-tee-oh-sar-KOH-muh)

A cancer of the bone that usually affects the large bones of the arm or leg. It occurs most commonly in young people and affects more males than females. Also called osteogenic sarcoma.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

pelvis (PEL-vus)

The lower part of the abdomen, located between the hip bones.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

prostate (PROS-tayt)

A gland in the male reproductive system. The prostate surrounds the part of the urethra (the tube that empties the bladder) just below the bladder, and produces a fluid that forms part of the semen.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

puberty (PYOO-ber-tee)

The time of life when a child experiences physical and hormonal changes that mark a transition into adulthood. The child develops secondary sexual characteristics and becomes able to have children. Secondary sexual characteristics include growth of pubic, armpit, and leg hair; breast enlargement; and increased hip width in girls. In boys, they include growth of pubic, face, chest and armpit hair; voice changes; penis and testicle growth, and increased shoulder width.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

radiation (RAY-dee-AY-shun)

Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

retinoblastoma (REH-tih-noh-blas-TOH-muh)

Cancer that forms in the tissues of the retina (the light-sensitive layers of nerve tissue at the back of the eye). Retinoblastoma usually occurs in children younger than 5 years. It may be hereditary or nonhereditary (sporadic).

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

sacrum (SAY-krum)

The large, triangle-shaped bone in the lower spine that forms part of the pelvis. It is made of 5 fused bones of the spine.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

sarcoma (sar-KOH-muh)

A cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

shinbone (SHIN-bone)

The larger of two bones between the knee and ankle. Also called tibia.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

spine (spine)

The bones, muscles, tendons, and other tissues that reach from the base of the skull to the tailbone. The spine encloses the spinal cord and the fluid surrounding the spinal cord. Also called backbone, spinal column, and vertebral column.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

symptom (SIMP-tum)

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

syndrome (SIN-drome)

A set of symptoms or conditions that occur together and suggest the presence of a certain disease or an increased chance of developing the disease.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

tailbone (TAYL-bone)

The small bone at the bottom of the spine. It is made up of 3-5 fused bones. Also called coccyx.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

therapy (THAYR-uh-pee)

Treatment.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

thyroid (THY-royd)

A gland located beneath the larynx (voice box) that makes thyroid hormone and calcitonin. The thyroid helps regulate growth and metabolism. Also called thyroid gland.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

tissue (TIH-shoo)

A group or layer of cells that work together to perform a specific function.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

tumor (TOO-mer)

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

will (wil)

A legal document in which a person states what is to be done with his or her property after death, who is to carry out the terms of the will, and who is to care for any minor children.

Source: The National Cancer Institute's Dictionary of Cancer Terms(http://www.cancer.gov/dictionary)

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